Ezer Dry Eye Sapphire

The Sapphire is designed to perform tear film tests, from tear quality to Meibomian Gland analysis. It is the new instrument for individual tear film analysis that enables detailed and rapid structural investigation of tear composition.

All in One

Evaluation of all layers of the tear film

Fully Automatic Protocol

INTERFEROMETRY

Its pin has been designed to fit perfectly into the hole that can be seen when the plate used for the tonometer is removed. The closer the device is to the eye, the larger the area illuminated by the instrument. The light reflected by the tear film can be observed as a white circular area covering almost the entire cornea.

This examination is of fundamental importance, as the majority of dry eye diseases are caused by an insufficiency in the quantity of the lipid layer. The evaluation of the lipid layer is part of a comprehensive Dry Eye assessment. Understanding what is causing the Dry Eye will help determine the best treatment option.

LIPID LAYER ANALYSIS

The LLT measurements are presented on an easy-to-understand color scale. Identification is performed using the international grading scale by Dr. Guillon.

TEAR MENISCUS

Low tear production can result in aqueous tear deficiency (ATD) and cause dry eye symptoms. However, measuring tear volume is difficult, as the currently available methods are invasive and irritating.

NIBUT Thanks to a single video, the physician can obtain a wealth of information:

▪ Automatic NIBUT
▪ Average of more than one value
▪ Graph to understand the trend of tear film stability throughout the video
▪ Tear topography showing all tear film breakups over time.

MEIBOGRAPHY

The Meibomian glands (MGs) play an important role in tear quality by producing lipids (meibum) that form part of the superficial tear film. MG dysfunction destabilizes tear composition, resulting in evaporative dry eye.

The system automatically analyzes images captured through a sensitive infrared (NIR) camera to locate the Meibomian Glands in a guided manner:

• A single examination valid for both the upper and lower eyelids;
• Automatic percentage calculation of Meibomian Gland loss area

Meibomian Gland Dysfunction (MGD) is characterized by chronic and diffuse abnormalities of the Meibomian Glands, as well as by alterations in the secretion and chemical composition of the meibum.

BLEPHARITIS AND CYLINDRICAL DANDRUFF
CYLINDRICAL DANDRUFF AND BLEPHARITIS

The surface of human skin harbors millions of bacteria, although some people have more than the average amount. Blepharitis is an inflammation caused by certain bacteria found at the base of the eyelashes. These produce dandruff-like scales on the skin, which leads to infection and inflammation.

The problems with the Meibomian Glands (meibomianitis) in the eyelids can also cause blepharitis. The development of inflammation is also associated with risk factors such as dandruff, dry eye, acneiform rosacea, or bacteria.

This test aids in the detection of blepharitis. It can be performed on the external surface of the eyeball and the eyelids. The process includes:

• Examining the Meibomian Gland openings, the base of the eyelashes, and the eyelid margins using a bright light.
• Checking for abnormalities by assessing the quantity and quality of tears.

The type of blepharitis can be determined based on the appearance of the eyelid margins. If the symptoms frequently presented by patients include slightly sticky eyelids, thickened eyelid margins, and absent/misdirected eyelashes, then the type of blepharitis is diagnosed as Staphylococcal.

When the patient presents with obstruction of the Meibomian Glands in the eyelids, poor tear film quality, and redness of the palpebral conjunctiva, meibomian blepharitis is diagnosed. If a hard, compact crust forms on the eyelashes, and upon its removal small ulcers appear on the skin, ulcerative blepharitis is diagnosed.

WHAT IS DEMODEX BREVIS?
Demodex brevis is a type of mite found on human skin. Like its counterpart Demodex folliculorum, D. brevis occurs naturally. D. brevis is so small that the mites cannot be seen with the naked eye (macroscopically).

DR. LUCA VIGO’S SUGGESTIONS

Diagnostic and treatment suggestions based on the clinical procedure of Dr. Luca Vigo and the Carones study (Milan, Italy).

A comprehensive database focused on dry eye enables proper understanding and diagnosis of dry eye patients. With the practical data results tab, the ophthalmologist can review the complete tear film evaluation, determining all deficiencies that cause the pathology while simultaneously understanding what treatment is needed to address each case.

DIAGNOSTIC SUGGESTION
Ocular surface data and pathology classification

Thanks to the expertise of Studio Medico Carones with Dr. Luca Vigo, TFA includes a suggestion algorithm capable of proposing a possible treatment approach for each patient.

TREATMENT MANAGEMENT

Through the TREATMENT MANAGEMENT tab, the software allows the physician to complete the database with all the medications, supplements, and treatments available in their practice. Any treatment, such as vitamins, Omega-3, ophthalmic drops, warm compresses, and IPL/Radiofrequency, can be loaded into the software to prescribe products from the brands the physician prefers. The complete report with the diagnosis and the treatment suggested by the ophthalmologist will be printed directly.

PROTOCOL

(MD L.VIGO Studio Carones Milano) is now available and suggests treatment based on our experience with key opinion leaders (KOL).

All users can customize their own protocol by adding treatment procedures to be automatically selected right after performing the examinations (this also makes it possible to delegate the diagnosis to an assistant).

OTHER POSSIBLE EXAMINATIONS
AN EVALUATION OF GRADING SCALES FOR MEIBOGRAPHY IMAGES

The study of Meibomian Gland dysfunction appears to be of growing interest in research and clinical practice. Consequently, the evaluation of Meibomian Gland morphology through Meibography is of great interest to both researchers and clinicians.

WHITE-TO-WHITE MEASUREMENT

Evaluation of the corneal diameter from limbus to limbus (White-to-White distance, WTW).

BULBAR HYPEREMIA CLASSIFICATION

By acquiring an image of the conjunctiva, it will be possible to compare the patient’s condition with different international classification scales.

PUPILLOMETRY

The measurement of pupil diameter has gained increasing importance in the field of refractive surgery. Larger scotopic pupil sizes may be partially responsible for the appearance of postoperative symptoms such as halos, glare, and monocular diplopia. Refractive surgeons also need accurate scotopic pupil measurement to determine appropriate treatment zones for excimer laser, corneal, and intraocular surgery.

COMPARISON WITH THE MAIN INTERNATIONAL GRADING SCALES

EFRON – CCLRU – JENVIS – GLAUCOMA – FERNING TEST (Ferning Test) – MEIBOGRAPHY (Meibography)

DIFFERENT AVAILABLE REPORTS

The TFA software is a platform dedicated to dry eye that allows, in addition to assisting in the diagnosis and classification of diseases, printing and saving various medical reports, offering the most professional and clinical solutions for patients. For customer satisfaction, it is often advisable to provide technical documentation related to the examinations performed. Thanks to the various print reports of the Sapphire device, you will have the ability to visually explain and simply demonstrate the status of the pathology. Furthermore, it is possible to explain how the pathology has evolved over time.

COMPREHENSIVE REPORT

Comprehensive report with all results and images used to explain to the patient any dry eye category.

TREATMENT REPORT

Patient-oriented report explaining the causes of the pathology and the recommended treatments.

FOLLOW-UP REPORT

For each value it is possible to display the trend line before/during/after treatment.

DAILY REPORT

Brief single-page report to display all examination results at a glance.

MONOCULAR REPORT

For saving and printing a single exam of interest.

BINOCULAR REPORT

To save the same examination of both eyes in a single PDF file.

The Sapphire device provides 3D imaging to help you explain the cause of dry eye and support your treatment recommendations. It gives you the ideal tool to clearly explain the cause of the patient’s ocular discomfort, while helping each patient understand the rationale behind your recommendations. The Sapphire device allows you to offer peace of mind to your patients, with the assurance that you are using the most advanced technology for accurate diagnosis and treatment.